Objective To investigate the prevalence, characteristics and risk factors of superior vena cava and auxiliary branchs thrombosis in hemodialysis patients with internal jugular venous indwelling catheter. Methods A total of 43 cases on hemodialysis (HD) with indwelling short-term catheter in internal jugular vein from June to December in 2007 were enrolled in this study. The clinical data and biochemical indicators were collected to investigate the prevalence, characteristics and risk factors of venous thrombosis around indwelling catheter, such as, superior vena cava and auxiliary branehs in these patients. Results Short-term double Iumen internal jugular venous catheter were placed in 43 HD patients. Different degrees of central vein thrombosis were found in 21 of the 43 HD patients (48.8%). The ratio of thrombosis in jugular vein, brachiocephalic vein, subclavical vein and uperior vena cava was 100% (21/21), 28.6% (6/21), 23.8%(5/21) and 19.0%(4/21), respectively. Ten of the 21 HD patients (47.6%) with central vein thrombosis presented clinical symptoms. Five cases developed edema of the upper extremity, 2 cases had new-onset symptom's pulmonary embolism, and 3 eases developed blood overflowed from inlet port of circum-catheter. The ratio of diabetes mellitus, malignant tumor, the prevalence of increased level of serum lipoprotein a and plasma homocysteic acid were significantly higher in the HD patients with central vein thrombosis than that in those without central vein thrombosis. The odds ratio of diabetes mellitus, malignant tumor, high serum lipoprotein a and high plasma homocysteic acid was 5.758, 4.750, 6.967 and 8.533, respectively. Conclusions The prevalence of central vein thrombosis in HD patients with short-term indwelling catheter in internal jugular vein is quite high. Its clinical symptom is insidious but dangerous. Diabetes mellitus, malignant tumor, high serum lipoprotein a and high plasma homocysteic acid may be the important risk factors of central vein thrombosis in above HD patients.

Objective To investigate the prevalence of depression in maintenance hemodialysis (MHD) patients. Additionally,to explore the relationship between depression and microinflammation,serum zinc levels and malnutrition in MHI) patients.Methods One hundred fifty-seven MHD patients were enrolled in this study.The patients were divided into two groups:depressed patients and non-depressed patients,according to the Beck Depression Inventory.The following data were collected:social factors,biochemical index,serum zinc levels,malnutrition-inflammation (MIS) score and IPI score.Binary logistic regression analysis was performed.Results Symptoms of depression were exhibited by 45.2％ of MHD patients (71/157 ).Symptoms of moderate or severe depression were exhibited by 24.2 ％ of the patients ( 38/157 ).However,signicant differences were shown in age [( 62 ± 11 ) vs.( 50 ± 13 ) years old],MIS score [( 7.2 ± 2.2 ) vs.( 3.3 ± 1.6 ) scores],white blood cell count [( 6.4 ± 1.8 ) × 109/L vs.( 5.8 ±1.5) × 109/L],high sensitivity C-reactive protein (hsCRP) [(9 ±6) vs.(4 ±4) mg/L],hemoglobin [(10.7±1.5) vs.(11.3±1.5) g/L],albumin[(33±4) vs.(37 ±3) g/L],fasting glucose [(6.7±3.5) vs.(5.6±2.1) mmol/L],serum zinc [(8.5±2.6) vs.(10.1 ±2.9) μmol/L] between depressed patients and non-depressed patients ( All P ＜ 0.05 ). Binary logistic regressive analysis revealed that the independent risk factors of depression in MHD patients were their MIS score ( OR =2.908,95％ CI =2.037 -4.151 ),as well as their hsCRP( OR =1.217,95％ CI=1.075 - 1.370),serum zinc and fasting glucose levels(OR=1.315,95％CI=1.039 - 1.664).Conclusions There was a high prevalence of depression in MHD patients.Depression is also highly correlated with microinflammation,serum zinc levels,and malnutrition.MIS scores,hsCRP,serum zinc levels and fasting glucose levels.

Objective To investigate the potential contributing effects of metabolic syndrome (MS) on cardiovascular events and mortality in maintenance hemodialysis (MHD) patients.Methods According to the diagnostic criteria for MS set by Chinese Diabetes Society,201 subjects undergoing MHD were assigned into MS group(n =78) or non-MS group (n =123),in August 2009.General and laboratory data were collected for cross-sectional analyses,and the participants were followed up for 36 months.Cardiovascular events,cause of death and time were recorded for longitudinal analyses.Results Prevalence of MS was 38.8％.Weight,waist circumference,triglyceride,total cholesterol,low density lipoprotein,fasting glucose level,uric acid and high-sensitivity C-reactive protein were significant higher in MS group compared to non-MS group,but duration of dialysis and high-density lipoprotein were lower (P ＜ 0.05).During the 36 months follow-up,cumulative incidence of cardiovascular events,cardiovascular and all-cause mortality were 41.0％ (32/78),19.2％ (15/78),28.2％ (22/78),in MS group respectively.Those of non-MS group were 22.8％ (28/123),10.6％ (13/123),17.1％ (21/123).There was significant difference between patients with and without MS in cumulative incidence of cardiovascular events (x2 =7.601,P =0.006).There was relationship between the number of metabolic syndrome parameters and cardiovascular events (r =0.236,P =0.001).Kaplan-Meier curves showed the relationship between two groups did not remained statistically significant in cardiovascular and all-cause mortality.Impaired glycometabolism in 5 parameters of MS was a cardiovascular mortality risk factor in MHD patients.Conclusions The prevalence of MS is high in MHD patients.MS is a risk factor of cardiovascular events,but it is not associated with cardiovascular and all-cause 3-year mortality in patients with MHD.

Objective To investigate the potential contributing effects of fasting plasma glucose on cardiovascular events in diabetic patients treated with maintenance hemodialysis.Methods According to fasting plasma glucose,154 patients undergoing maintenance hemodialvsis in our department were assigned into group A (n =84) nondiabetic with normal fasting blood glucose,group B (n =41) diabetic with good control of fasting blood glucose,and group C (n =29) diabetic with poor control of fasting glucose.Anthropometric and laboratory data were collected,and the participants were followed up for 36 months.Cardiovascular events and hypoglycemia were recorded and analyzed.Results Highly-sensitive C reactive protein (hs-CRP),triglyceride,and waist circumference were significantly higher in group B and group C compared with group A.Bodv mass index in group C was the highest while high density lipoprotein-cholesterol and intact parathyroid hormone levels were the lowest among 3 groups (P＜0.05).During the 36 months follow-up,47 cases of cardiovascular events occurred.Kaplan-Meier curves showed that cumulative incidence of cardiovascular events was significantly higher in group C than group A and B (both P＜0.01),and no significant difference was found between group A and B.Cox regressive analysis revealed that fasting plasma glucose and hs-CRP were independant risk factors for cumulative incidence of cardiovascular events (P＜0.05 or P＜0.0l).Conclusions If fasting plasma glucose is contmlled within the range of 5.6 to 7.2 mmol/L,cardiovascular outcomes may be significantly ameliorated in diabetic patients treated with maintenance hemodialysis.

Objective To investigate the effects of edaravone on myocardial fibrosis induced by isoproterenol (ISO) in rats, and to discuss the correlation between the level of transforming growth factor-β1 (TGF-β1) and the myocardial fibrosis. Methods Forty male SD rats were randomly divided into five groups, namely control group, model group and edaravone groups (low, medium and high doses). Isoproterenol was used to establish the rat model of myocardial fibrosis. Edaravone groups were given edaravone [3, 5 and 10 mg/(kg · d)] to intervene for 14 days. The activity of superoxide dismutase (SOD) and the level of malondialdehyde (MDA) were examined after 15-d treatment. The left ventricular mass index (LVMI) and collagen volume fraction (CVF) were examined. The expression of TGF-β1 was detected by Western blot assay and immuno-fluorescence method. Results The content of MDA and LVMI were significantly higher in model group than those of the control group (P<0.01),whereas the content of SOD was significantly lower in model group than that of the control group (P<0.01). Compared with model group, the expression level of MDA decreased with the increased intervention dose of edara-vone (P<0.05), while SOD expression level increased (P<0.05). There was no significant difference in the level of SOD be-tween middle dose edaravone group and the control group. LVMI was decreased with the increased doses of edaravone ( P<0.01). There was no significant difference in LVMI between the high dose of edaravone group and the control group. Com-pared with the control group, the expression level of TGF-β1 was significantly increased in model group (P<0.01). The ex-pression level of TGF-β1 was reduced with the increased doses of edaravone. CVF was significantly increased in model group compared with that of control group (P<0.001). CVF decreased with the increased doses of edaravone in medium and high doses of edaravone groups, but they were higher than that of control group (P<0.01). TGF-β1 was positively correlated with MDA, LVMI and CVF (r=0.931, 0.879 and 0.930, P<0.001). SOD was negatively correlated with TGF-β1 (r=-0.892, P<0.001). Conclusion Edaravone can relieve myocardial fibrosis by inhibiting oxidative stress and TGF-β1 in rats.

Objective To investigate the potential correlation between serum magnesium and malnutrition-inflammation-atherosclerosis (MIA) syndrome in maintenance hemodialysis (MHD) patients.Methods A total of 120 patients who received MHD in Department of Blood Purification of Beijing Chaoyang Hospital from March to August 2013 were enrolled.Anthropometric and laboratory data were collected for the analysis of correlation between serum magnesium and indicators relating to malnutrition,chronic inflammation,and atherosclerosis,and the analysis of relevant factors of MIA syndrome.Results In the 120 MHD patients,the mean serum magnesium level was (1.11 ±0.14) mmol/L.44 patients had malnutrition (36.7％),whose serum magnesium level was significantly lower than that of patients in normal nutritious status [(1.04 ±0.12) mmol/L vs.(1.14 ±0.15) mmol/L,t =3.576,P =0.001] ; 43 patients had chronic inflammation (35.8％),with serum magnesium level significantly lower than that of patients without inflammation [(1.07 ±0.13) mmol/L vs.(1.13 ±0.15) mmol/L,t =2.138,P =0.035]; 79 patients had atherosclerosis (65.8％),whose serum magnesium level was significantly lower than that of patients without atherosclerosis [(1.08 ±0.12) mmol/L vs.(1.15 ±0.08) mmol/L,t =0.385,P =0.019] ; and 26 patients had MIA syndrome (21.7％),whose serum magnesium level was significantly lower than that of non-MIA patients [(1.02 ± 0.10) mmol/L vs.(1.13 ± 0.14) mmol/L,t =3.534,P =0.001].Serum magnesium level was found negatively correlated with high-sensitivity C-reactive protein (hs-CRP,r =-0.237,P =0.010) and carotid intima-media thickness (IMT,r =-0.331,P =0.000),and positively correlated with serum albumin,blood urea nitrogen,serum creatinine,uric acid,serum potassium,triceps skin-fold thickness,mid-arm circumference,mid-arm muscle circumference and hemoglobin (r =0.191,P =0.037; r =0.345,P =0.000; r =0.242,P=0.008; r =0.282,P=0.002; r=0.254,P=0.005; r=0.265,P=0.011; r=0.233,P=0.018; r=0.282,P=0.007; r=0.374,P =0.000).Multivariate logistic regression analysis showed that age (OR =1.142,95％ CI =1.026-1.271,P=0.049),hs-CRP (OR=1.415,95％ CI=1.152-1.740,P=0.001),IMT (OR =1.386,95％ CI=1.009-1.904,P=0.044),serum albumin (OR =0.944,95％ CI=0.910-0.978,P=0.002) and serum magnesium (OR =0.886,95％ CI =0.788-0.996,P =0.042) were related factors of MIA syndrome.Conclusions Serum magnesium level is correlated to malnutrition,inflammation,atherosclerosis,and MIA syndrome in MHD patients.

To cultivate medical talents with innovative ability is necessary for quality education,medical development and medical mode transformation.The traditional education mode cannot acclimatize itself to innovation education.So,we should renovate the education concept,train students in innovative ability and put quality education into practice.

Objective: To establish the optimum preparation procedure for Grub Eye Drops. Methods: The amount of extract abtained from extraction solutions, the contents of glutamic acid and glycine, nitrogen content and TLC spots were used to evaluate the extraction procedure for Grub Eye Drops by orthogonal design. Results: The optimum extraction condition was A 3B 2C 1. That is adding ten times amount of water to soaking for 30min, decocting for 1.5h, filtering to obtain filtrate Ⅰ, adding seven times of water into filter residue, decocting for 1h to obtain filtrate Ⅱ, combining filtrate Ⅰ and Ⅱ. Conclusion: The experimental method is suitable for the productive preparation of Grub Eye Drops.

Objective To explore aspirin resistance (AR) and its relevant influencing factors in patients on maintenance hemodialysis (MHD).Methods Patients on MHD who visited Beijing Chaoyang Hospital from June 1 to 30,2011 were enrolled in this study.A total of 150 age and gender matched individuals with normal renal function were taken as control group.Anthropometric data,biochemistry parameters,ultrasonography and thromboelastograph (TEG) were inspected in the both groups.AR was defined as inhibiting rate of acetylsalicylic acid drugs [MA (AA)] ＞ 50％ by TEG.Results Among the total 391 patients on MHD,hypercoagulation was found in 18 patients (4.6％),nomal coagulation in 288 patients (73.7％) and hypocoagulation in 85 patients (21.7％).Pearson's correlation analysis revealed that the reaction time (R) and the thrombus maxithrombelastic degree (MA) values were not correlated with the levels of hemoglobin and platelet in MHD patients.A total of 306 patients with hypercoagulation and normal coagulation were chosen as the MHD group.Compared with the control group,higher high sensitivity C reactive protein (hsCRP),homocysteine (Hcy) and R value were observed in the MHD group (P ＜ 0.05),while MA was significantly lower in the MHD group.Statistically higher incidence of AR was shown in the MHD group (48.0％ vs 20.0％,P =0.00).Patients in the MHD group were divided into the AR group and the aspirin sensitive (AS) group by the result of TEG.Compared with the AS group,patients in the AR group were found to be older with a higher female/male ratio,longer dialysis sustained time,higher ratio of diabetes history,higher hsCRP,Hcy and fasting blood glucose (FBG) and MA.They also manifested a higher incidence of cardiovascular and cerebrovascular diseases,peripheral vascular disease and arteriovenous fistulas with thrombosis with more spots of carotid artery and higher intima thickness of carotid artery (IMT) (all P values ＜0.05).Lower R value was shown in the AR group.Binary logistic regressive analysis revealed that the ratio of diabetes history,age and dialysis sustained time.Hcy and hsCRP were the independent risk factors for AR in patients on MHD.A total of 289 patients on MHD with atherosclerosis were followed up for the mean time of 18.0 months with no hemorrhage found in the process.Cox proportional hazards regression modeling demonstrated that AR was associated with the major adverse longterm outcome of the vascular events [HR =0.40,95 ％ CI 0.29-0.72,P =0.00].Conclusions The ratio of platetet activation in patients on MHD is significantly lower than in those with normal renal function.Small dose of aspirin could be prescribed for the patients on MHD with atherosclerosis to prevent vascular events.The incidence of AR is 48.0％ in the MHD group and the independent risk factors for AR in MHD patients are the ratio of diabetes history,age,dialysis sustained time,Hcy and hsCRP.AR is associated with the major adverse long-term outcome of acute vascular events.